End religious exemption

By Paul A. Offit

Posted: May 10, 2013

The Jerry Sandusky scandal at Penn State generated a public outcry for stronger laws against child abuse and neglect. Several bills have been introduced that purportedly provide a "complete overhaul" of Pennsylvania's child-protection laws.

For example, Senate Bill 20 makes it clear that any adult who "causes serious bodily injury," either by "kicking, biting, stabbing, cutting, or throwing a child," or "forcefully shakes or slaps a child under one year of age," or "causes serious physical neglect," or "causes a child to be near a methamphetamine lab," or "operates a vehicle in which a child is a passenger while driving under the influence of alcohol," has committed child abuse.

Unfortunately, one group of children has been left behind.

The bill states that "if a child has not been provided needed medical or surgical care because of seriously held religious beliefs of the child's parents ... the child shall not be deemed to be physically or mentally abused." In other words, if parents decide not to give their children antibiotics for meningitis, or insulin for diabetes, or chemotherapy for cancer, or surgery for intestinal blockage, they won't be held accountable. According to the bill, parents are abusive if they slap their 1-year-old child, but not if they withhold lifesaving therapies.

The problem of religious-based medical neglect in Pennsylvania isn't theoretical.

I was a young attending physician at the Children's Hospital of Philadelphia in 1991 during a massive measles epidemic - one that occurred almost 30 years after the invention of a measles vaccine. The outbreak centered on two fundamentalist churches in the city - Faith Tabernacle and First Century Gospel - which didn't believe in medical care. None of the children of church members was vaccinated. Among members of those two churches, 486 people were infected and six died from measles. The virus also spread to the surrounding community. Among non-church members, 938 people were infected and three died. The nine who died were all children. Church members had made a decision for their own children as well as those with whom their children had come in contact.

The spread of highly contagious diseases hasn't been the only problem.

Philadelphia parents Roger and Dawn Winterborne let five children die of pneumonia without medical care because of their religious beliefs. Only after the fifth death did child protective services become aware of these tragedies and briefly monitor the family. Later, the couple moved to Harrisburg, where a sixth child died of untreated pneumonia.

In 2002, an anonymous caller alerted authorities to the neglect of 9-year-old Benjamin Reinert. Benjamin's father, Paul Reinert, was a member of Faith Tabernacle. Child-protection workers visited twice and instructed the father to seek medical care if the boy's condition worsened. One day later, Benjamin Reinert was dead. An autopsy revealed that the boy had died from a treatable form of leukemia.

In 2009, Herbert and Catherine Schaible chose prayer instead of antibiotics for their 2-year-old son, Kent, who died from bacterial pneumonia. The Schaibles received 10 years' probation. Recently, their 8-month-old son died without medical care. Their other seven children have now been removed from the home.

The 14th Amendment to the Constitution states that "no state shall ... deny to any person within its jurisdiction the equal protection of the laws." Children whose parents hold certain religious beliefs shouldn't be afforded less protection than other children. That the commonwealth has allowed children to die from measles, bacterial pneumonia, or leukemia in the name of religion is inexplicable. That it continues to allow such abuse in the face of recent deaths is unconscionable.

Pennsylvania should repeal its religious exemptions for medical neglect. Otherwise, children will continue to suffer and die needlessly.

Paul A. Offit, M.D., is chief of the division of infectious diseases at the Children's Hospital of Philadelphia and professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania. E-mail him at offit@email.chop.edu.